Defendants Q.M. (Quentin) and C.M. (Carol) appeal separately from the August 8, 2012 Family Part judgment terminating their parental rights to their then five-year-old daughter, P.M. (Paula).[1] On these appeals, which we have consolidated, defendants contend that the Division of Child Protection and Permanency (Division)[2] did not prove by clear and convincing evidence the four prongs of the best interests test. N.J.S.A. 30:4C-15.1a. The Law Guardian supported termination before the trial court and, on appeal, joins the Division in urging us to affirm.

Based on our review of the record and applicable law, we are satisfied that the Division proved by clear and convincing evidence the requisite statutory factors required to terminate defendants' parental rights. Accordingly, we affirm.

I.

We derive the following facts from the trial record. Carol and Quentin are the biological parents of Paula, who was born in the spring of 2007. Carol is also the mother of three other children (from two different fathers), none of whom live with her. Quentin has been in and out of prison for most of his adult life. In August 2007, when Paula was approximately four-months-old, Quentin was incarcerated, and not released until May 2010.

The Division first became involved with Carol and Paula on January 30, 2009, when it received an anonymous referral reporting that Carol smoked marijuana, used cocaine, and drank intoxicating amounts of alcohol, all in the presence of Paula. The referent also described Carol's associates as dangerous. The Division investigated, but was unable to substantiate the allegations.

On July 7, 2009, the local police went to Carol's home and found L.M., Carol's mother, who lived in the home, "highly intoxicated." Between August and December 2009, the police responded to other calls involving domestic disputes in Carol's home.

On December 16, 2009, the Division received a referral from a local police officer, who reported that there was a domestic dispute involving Carol, T.Q.[3] (Carol's paramour at the time), and L.M. During the dispute, T.Q. was stabbed and the home was vandalized, but the officer could not determine responsibility for the stabbing or vandalism. The officer further reported that a witness stated that two-year-old Paula was present during the incident and placed at risk of harm.

Later the same day, two Division caseworkers met with Carol and L.M. at the police station and immediately noticed they both appeared intoxicated and were "belligerent and agitated." Carol stated that she had been at her grandmother's home with T.Q. and L.M., as well as Paula and T.Q.'s three-year-old son. Carol stated that after they left her grandmother's home, T.Q. started arguing with her, and when they arrived home, T.Q. began to strangle her; however, Carol denied stabbing him.

Next, the caseworkers went to Paula's maternal uncle's home and found Paula sleeping. The uncle informed the caseworkers that Carol and T.Q. fight all of the time and T.Q. has strangled Carol on multiple occasions. As a result of the incident, and the Division's concerns with Carol's substance abuse, the Division substantiated the claims against Carol for neglect and executed an emergency removal of Paula.

On December 17, 2009, while examining Paula, a Division nurse discovered that her front teeth were decayed and that she had scars on her stomach and back. Paula's decayed teeth required four tooth extractions, two root canals, and four fillings. On December 28, 2009, after attending substance abuse treatment, Carol tested positive for marijuana.

On May 13, 2010, Quentin was released from prison and placed in a halfway house in Newark, where he remained until August 2010. On May 18, 2010, Quentin stipulated that due to his incarceration, he was unable to provide adequate care for Paula thereby placing her at risk of harm. Thereafter, Quentin was incarcerated from March 25, 2011 through March 30, 2011, and again from April 14, 2011, through May 6, 2011.

In May 2010, Paula was moved to another foster parent, after her then foster mother advised the Division she could no longer care for Paula. Paula was returned to Carol's care on February 8, 2011, but was removed again three days later due to allegations of domestic violence and alcohol abuse in the home. Thereafter, the Division placed Paula in another foster home, but had to remove her following sexual abuse allegations against the foster father. The Division then placed Paula with S.A., Carol's cousin, on June 27, 2011, where she remains today. This was Paula's fourth placement. S.A. has expressed that she would adopt Paula if defendants' parental rights were terminated.

On July 7, 2011, the Division filed its complaint for guardianship, and a five-day guardianship trial was conducted in the Family Part between May 21, 2012 and June 5, 2012. The Division offered testimonial evidence from its caseworkers, Jennifer Mazzola and Sandro Villa Vicencio, who recounted the history of the Division's involvement with the family, and the Division's efforts to assist defendants reunify with their daughter. The Division also presented the testimony of its psychological and bonding expert, Elayne Weitz, Psy.D.

Dr. Weitz testified concerning psychological evaluations she conducted of Carol and Quentin, as well as bonding evaluations between each of them with Paula, and S.A. with Paula. Based on her psychological evaluation of Carol completed on January 20, 2012, Dr. Weitz testified that

the most significant concern I had was that she really took no responsibility for the child's initial or continued placement in foster care . . . therefore, [she] also created the impression that there was not a whole lot that she would do differently once the child is back in her care.

Additionally, Dr. Weitz stated that she shared the concerns of the Division that it was dangerous for Paula to be in a home where the police were regularly called and where she was regularly exposed to domestic violence and substance abuse. She also expressed concern that Carol's failure to recognize that her constantly intoxicated mother posed a threat to Paula. Dr. Weitz elaborated that a home with problems such as Carol's can impact a child's growth and development by making her "anxious, fearful, worried. . . . It can lead to sleeping issues, eating problems, difficulty concentrating in school."

Also, Dr. Weitz was concerned that Carol had no recent employment, noting that "[s]he was being supported by family members. She did not have a stable place to live and was living with her grandmother." Dr. Weitz opined that Carol was in denial regarding her substance use. Moreover, based on the fact that Carol voluntarily relinquished custody of her other children, Dr. Weitz expressed concern about Carol's ability "to run a home, work, and care for children[.]"

As to her evaluation of Quentin, Dr. Weitz testified that Quentin "seemed to take responsibility for some of the mistakes that he has made in the past, but also made it clear that he was not the one from whom [Paula] was removed." Dr. Weitz also expressed concern regarding Quentin's assessment of his time spent in prison, as he told her "you get out there and you have nothing and you end up doing bad things."

Dr. Weitz testified as to Quentin reporting about his lengthy criminal history, which began with an armed robbery when he was fifteen years old. Quentin further reported to Dr. Weitz that he went to jail on two separate occasions for selling drugs —— once for five years and again for three years.

As a result of her evaluation of Quentin, Dr. Weitz concluded that Quentin was unfit to parent Paula. Dr. Weitz elaborated that Quentin did not have a job, did not have a place to live, lacked parenting skills, and inconsistently visited Paula initially.

Regarding the bonding evaluation between Carol and Paula, Dr. Weitz described it as "pleasant." Specifically, Carol played and spoke with Paula appropriately. However, at one point during the evaluation, Paula raised her voice to Carol after Carol tried to insist that they play with dolls.

As to the bonding evaluation between Quentin and Paula, Dr. Weitz testified that

Paula was the least comfortable with her father. As a matter of fact . . . she was uncomfortable with her father, except maybe in the last few minutes of the session. During that time, she barely answered his questions. . . . When she wanted to do something, she would use one-word responses . . . . She was rude. She was fresh. She got angry at him when he tried to touch her. She pushed at [sic] him on one occasion.

As to the bonding evaluation between S.A. and Paula, Dr. Weitz testified that Paula was the "most animated" with S.A., noting that Paula "sought [S.A.'s] attention repeatedly" and S.A. "was the only one that [Paula] made mention of a relationship." Moreover, Dr. Weitz reported that S.A.'s "parenting was appropriate, attentive. [Paula] was the center of her attention."

Dr. Weitz summarized and compared the bonding evaluations to reach her conclusion that termination of each defendant's parental rights was warranted. She testified that although S.A. and Paula had not spent enough time with each other to form a true bond, "all the signs of bonding were present. . . . [A]ll the ingredients for healthy bonds were in this relationship and [Paula] was forming an attachment with [S.A.]" In regard to Carol, Dr. Weitz described the relationship between her and Paula as positive, but concluded that Carol "was not fit to parent [Paula] at this time." Dr. Weitz testified that removing Paula from S.A. "would be devastating for [Paula]." Although Dr. Weitz predicted terminating Carol's parental rights would be initially upsetting to Paula, she believed that S.A. would help Paula through it. Dr. Weitz opined that terminating Quentin's parental rights would cause no harm to Paula; moreover, Paula would "not accept [Quentin] as a primary caretaker. She would resent him and reject him, and . . . her behavior would completely deteriorate[.]"

Kenneth Schulman Ph.D. provided expert testimony on behalf of Carol. Dr. Schulman conducted a psychological evaluation of Carol, as well as bonding evaluations. He testified that Carol needs more psychotherapy to help her cope with unresolved issues from her childhood and to learn how to deal with stress. His testing "indicated that [Carol] was defensive in responding to the tests and [his] overall impression is that she does engage in denial."

Carol failed to inform Dr. Schulman that she had a relapse with alcohol following her completion of a drug treatment program. Dr. Schulman expressed concern that Carol would need subsequent treatment following her relapse. In Dr. Schulman's opinion, although Carol had completed a treatment program, "she minimized her difficulties with alcohol[.]" Further, Dr. Schulman testified that "if the maternal grandmother was under the influence of alcohol . . . [he] would have questions regarding [Paula's] safety in her presence."

When asked if Carol suffered from any psychological difficulties, Dr. Schulman stated that she "has a substance abuse problem which may or may not be in remission, and I think she has certain personality traits which, again, do not rise to the level . . . in my opinion, of major psychiatric disturbances or psychological disturbances, but there are emotional issues that are impacting upon her." Further, if these issues were to go untreated, Dr. Schulman opined that they can "adversely impact her ability to place her child's needs before her own. If her judgment becomes impaired, it can impair her ability to act in a protective manner."

As to the bonding evaluation of Carol with Paula, Dr. Schulman testified that Carol was appropriate and attentive. During the evaluation both Carol and Paula were interactive with each other. As to the bonding evaluation of S.A. with Paula, Dr. Schulman testified that "[i]t was equally as positive, " noting that the interaction level "was not substantially different" than when Paula was with Carol. As such, Dr. Schulman opined that Paula had a positive attachment to both Carol and S.A.

In Dr. Schulman's opinion, if Carol's parental rights were terminated Paula would "experience some distress[, ]" but it would not be "insurmountable." According to Dr. Schulman, S.A. could be "one agent" in mitigating any harm Paula might suffer. He stated that Paula would suffer similar harm if she were removed from S.A.'s care and returned to her mother.

Dr. Schulman acknowledged that, as of the time of trial, Carol was not ready to parent Paula. He further agreed that Paula would suffer substantial harm if permanency and stability were not established soon. Dr. Schulman testified that he could not formulate an opinion as to whether Carol's parental rights should be terminated.

Dr. Harold Goldstein testified as an expert on behalf of Quentin. He testified regarding a psychological evaluation he completed of Quentin, as well as a bonding evaluation of Quentin and Paula.

As to the psychological evaluation, Dr. Goldstein testified that Quentin "does qualify for an antisocial personality disorder" diagnosis. According to Dr. Goldstein, Quentin had chosen to live a criminal lifestyle, but it is possible he could change. Although Quentin did not have a job at the time of the evaluation, Dr. Goldstein testified that Quentin expressed a genuine determination to obtain full-time employment.

As to the bonding evaluation, Dr. Goldstein emphasized that he only observed Quentin with Paula for about thirty minutes. He testified that Quentin seemed to enjoy being with Paula. According to Dr. Goldstein, "they both felt comfortable with each other, they really enjoyed playing with each other." However, Dr. Goldstein noted that "there wasn't a lot of physical affection . . . not that I saw. Not a lot of kissing or hugging [or] anything like that."

Dr. Goldstein testified that Quentin failed to inform him about a recent January 2012 arrest. He agreed that if Quentin were incarcerated due to that arrest it would be harmful to Paula. Dr. Goldstein stated that he did not conduct a comparative bonding evaluation of Paula with S.A. He agreed it would be important to know how well Paula was doing in her current placement. Moreover, Dr. Goldstein testified that he did not review documentation showing that Carol had to help Paula get comfortable with Quentin during visits. As of the date of his testimony, Dr. Goldstein's recommendation was that Paula remain with S.A. to give Quentin time to develop a stronger bond with Paula and to gain better parenting skills. Dr. Goldstein testified that he was unable to predict how long it would take for Quentin to develop a relationship with Paula, but agreed that stability is important for any child.

Carol testified and denied being intoxicated during the incident that led to Paula's first removal, claiming that she only had two drinks. Although Carol claimed that she knew there was a court order barring Quentin from unsupervised contact with Paula, she admitted that she allowed him in the home. Carol also admitted that during the period when Paula was returned to her care, her apartment did not have hot water or gas. Additionally, Carol testified that her mother was homeless during this period and that she would allow her to come into her home and sleep even if she were intoxicated.

As to her living situation at the time of trial, Carol testified that she was living with her cousin, but claimed she had identified a potential apartment where she could move. As of the date of her testimony, Carol had not signed a lease for the apartment. Quentin did not testify.

On August 8, 2012, the trial judge entered a judgment of guardianship and issued a written opinion setting forth his reasons for concluding that the Division had met its burden of proving the elements of N.J.S.A. 30:4C-15.1a by clear and convincing evidence. This appeal followed.

II.

A parent's right to enjoy a relationship with his or her child is constitutionally protected. In re Adoption of Children by L.A.S., 134 N.J. 127, 132 (1993). "Parental rights, though fundamentally important, are not absolute. The constitutional protection surrounding family rights is tempered by the State's parens patriae responsibility to protect the welfare of children." In re Guardianship of K.H.O., 161 N.J. 337, 347 (1999).

Under N.J.S.A. 30:4C-15.1a, the Division can initiate a petition to terminate parental rights on the grounds of the "best interests of the child" if the following standards are met:

(1) The child's safety, health or development has been or will continue to be endangered by the parental relationship;

(2) The parent is unwilling or unable to eliminate the harm facing the child or is unable or unwilling to provide a safe and stable home for the child and the delay of permanent placement will add to the harm. Such harm may include evidence that separating the child from his resource family parents would cause serious and enduring emotional or psychological harm to the child;

(3) The division has made reasonable efforts to provide services to help the parent correct the circumstances which led to the child's placement outside the home and the court has considered alternatives to termination of parental rights; and

(4) Termination of parental rights will not do more harm than good.

"The four criteria enumerated in the best interests standard are not discrete and separate; they relate to and overlap with one another to provide a comprehensive standard that identifies a child's best interests." K.H.O., supra, 161 N.J. at 348.

Termination of parental rights permanently cuts off the relationship between children and their biological parents. . . . When the child's biological parents resist the termination of their parental rights, the court's function will ordinarily be to decide whether the parents can raise their children without causing them further harm. . . . The burden falls on the State to demonstrate by clear and convincing evidence that the natural parent has not cured the initial cause of harm and will continue to cause serious and lasting harm to the child.

The Supreme Court has recognized, however, that children have a "paramount need . . . for permanent and defined parent-child relationships." Id. at 26. There are "strong policy considerations that underscore the need to secure permanency and stability for the child without undue delay." In re Guardianship of D.M.H., 161 N.J. 365, 385 (1999).

"Appellate review of a trial court's decision to terminate parental rights is limited, and the trial court's factual findings should not be disturbed unless they are so wholly unsupportable as to result in a denial of justice." In re Guardianship of J.N.H., 172 N.J. 440, 472 (2002) (internal quotation marks and citation omitted). We are obliged to accord deference to the trial court's credibility determinations based upon the judge's opportunity to observe and hear the witnesses. Cesare v. Cesare, 154 N.J. 394, 412 (1998).

III.

A. The First Prong of the Best Interests Test.

To satisfy the first prong of the best interests standard, the harm shown by the parental relationship "must be one that threatens the child's health and will likely have continuing deleterious effects on the child." K.H.O., supra, 161 N.J. at 352. Generally, the proofs "focus on past abuse and neglect and on the likelihood of it continuing." N.J. Div. of Youth & Family Servs. v. F.H., 389 N.J.Super. 576, 609 (App. Div.), certif. denied, 192 N.J. 68 (2007) (quoting J.C., supra, 129 N.J. at 10).

The record contains ample evidence to support the court's determination that both parents' behavior exposed Paula to harm. As to the first prong, the judge credited Dr. Weitz's testimony that Carol took no responsibility for the Division's involvement with Paula and that she was dishonest during a psychological test. The judge found that Carol's mother is an alcoholic and Carol harmed Paula by exposing her to her mother while she was intoxicated. Additionally, the judge found that Carol "has an unstable living condition and exposed the child to domestic violence. She has no place to call home and no place to bring the child." The judge further credited Dr. Weitz's testimony that Carol had not benefited from substance abuse treatment that the Division provided her.

The judge noted that the expert witness for each defendant acknowledged that both parents did not have the present capability to care for Paula. In regard to Carol, the judge found that her current inability to parent would cause Paula harm if she were returned to her care. In regard to Quentin, the judge found that he "has never been able to parent his child in the past and he is still not ready." We are satisfied the record contains clear and convincing evidence to establish prong one.

B. The Second Prong of the Best Interests Test.

The second prong relates to parental unfitness. K.H.O., supra, 161 N.J. at 352. There are two ways to establish this prong: (1) the State must show that "the child's health and development have been and continue to be endangered" and "that the harm is likely to continue because the parent is unable or unwilling to overcome or remove the harm[;]" or (2) "the parent is unable to provide a safe and stable home for the child and that the delay in securing permanency continues or adds to the child's harm." Id. at 348-49.

As to the second prong, the judge found the evidence "overwhelming" that Carol is unwilling to eliminate the harm facing Paula. Specifically, the judge noted that Carol continually exposed Paula to her alcoholic mother, and permitted Quentin unsupervised contact with Paula in spite of a court order prohibiting same. The judge further found no evidence that Carol could financially support Paula.

Quentin argues that he had no involvement in the incident that led to Paula's initial removal from parental care. While Quentin may not have been physically present, due to his incarceration, harm, as addressed by the statute, is not limited to physical abuse or neglect. "Serious and lasting emotional or psychological harm to the child[] as the result of the action or inaction of their biological parent[] can constitute injury sufficient to authorize the termination of parental rights." In re Guardianship of K.L.F., 129 N.J. 32, 44 (1992). The failure of a parent to provide a "permanent, safe, and stable home" engenders the type of significant harm to a child addressed in the statute. D.M.H., supra, 161 N.J. at 383. Such is the case here.

Because of his illicit drug use, criminal activity, repeated incarcerations, unstable housing, and unemployment, Quentin failed to provide Paula with the security and consistency necessary for a child's healthy physical and emotional development. His "withdrawal of . . . solicitude, nurture, and care for an extended period of time" reflected a "failure to provide even minimal parenting, " which represents "a harm that endangers the health and development of the child." D.M.H., supra, 161 N.J. at 379 (citing K.H.O., supra, 161 N.J. at 352-54). Additionally, we note that Quentin's refusal to abide by the court order restricting him to supervised visitation contributed to the Division's decision to remove Paula from Carol's care in February of 2011.

In light of Quentin's history, it is reasonably foreseeable that defendant will reoffend and return to jail. The record contains no credible evidence to refute the Division's proofs demonstrating his unwillingness or inability to cease inflicting this harm upon Paula. See K.H.O., supra, 161 N.J. at 353 (holding the second prong is satisfied by evidence of "parental dereliction and irresponsibility."). We are satisfied the record contains clear and convincing evidence to establish prong two.

C. The Third Prong of the Best Interests Test.

The third prong requires the Division to make reasonable efforts to provide services to help the parent correct the circumstances which led to the child's placement outside the home. N.J.S.A. 30:4C-15.1a(3). Reasonable efforts will vary with the circumstances. F.H., supra, 389 N.J.Super. At 620. This factor requires the Division to make diligent efforts to make it possible to reunite the family. K.H.O., supra, 161 N.J. at 354.

As to the third prong, the judge found the Division provided both Carol and Quentin with substantial services in an attempt to reunify each parent with Paula. The record supports the trial judge's finding that the Division made ample efforts to reunify Paula with Carol, as summarized by the judge:

As of the date of trial, there were no alternatives to termination of parental rights. When defendants failed to take advantage of the services provided by the Division to address their problems, the Division's goal of reunification appropriately changed to termination due to Paula's need for permanency and stability. Neither Carol nor Quentin were able to adequately parent Paula at the time of trial. The record supports the judge's determination that reunification was no longer a viable option. We are satisfied the record contains clear and convincing evidence to establish prong three.

D. The Fourth Prong of the Best Interests Test.

The fourth prong, requiring proof that termination of parental rights will not do more harm than good, "serves as a fail-safe against termination even where the remaining standards have been met." N.J. Div. of Youth & Family Servs. v. G.L., 191 N.J. 596, 609 (2007). "The question ultimately is not whether a biological mother or father is a worthy parent, but whether a child's interest will be best served by completely terminating the child's relationship with that parent." N.J. Div. of Youth & Family Servs. v. E.P., 196 N.J. 88, 108 (2008). If a child can be returned to the parent without endangering the child, "the parent's right to reunification takes precedence over the permanency plan." N.J. Div. of Youth & family Servs. v. L.J.D., N.J.Super. 451, 492 (App. Div. 2012) (citing N.J. Div. of Youth & Family Servs. v. A.W., 103 N.J. 591, 608 (1986)). That the child has bonded with the foster parent does not alone justify the termination of parental rights. N.J. Div. of Youth & Family Servs. v. F.M., 375 N.J.Super. 235, 263-64 (App. Div. 2005).

A "concomitant finding of parental fault" also is required. N.J. Div. of Youth & Family Servs. v. D.M., 414 N.J.Super. 56, 74 (App. Div. 2010). However, where "a parent has exposed a child to continuing harm through abuse or neglect and has been unable to remediate the danger to the child, and the child has bonded with the foster parents who have provided a nurturing and safe home, . . . termination of parental rights likely will not do more harm than good." E.P., supra, 196 N.J. at 108.

In establishing this prong, the State should adduce testimony from a "well qualified expert who has had full opportunity to make a comprehensive, objective, and informed evaluation" of the child's relationship with the biological and foster parents. J.C., supra, 129 N.J. at 19. "The question . . . is whether, after considering and balancing the two relationships, the child will suffer a greater harm from the termination of ties with [his or] her natural parents than from the permanent disruption of [his or] her relationship with [the] foster parents." K.H.O., supra, 161 N.J. at 355.

As to the fourth prong, the judge credited Dr. Weitz's testimony that Quentin had no bond with Paula and termination of his parental rights will not do more harm than good. The judge found that Quentin presented no evidence to show harm would come to Paula if his parental rights were terminated. In regard to Carol, the judge credited Dr. Weitz's opinion that although Paula has a bond with her, Paula "'has not come to view her birth mother as someone who provides continuity of care where she can turn to, to comfort her and can allay her fears.'" Further, the judge credited Dr. Weitz's testimony that Paula has a bond with S.A. and would suffer harm if separated from her.

Here, the record supports the judge's determination that termination of Carol's and Quentin's parental rights will not do more harm than good. Terminating Quentin's parental rights will do little harm because he has no bond or relationship with Paula and has been in and out of prison her entire life.

As to Carol, although Paula has a bond with her, the evidence in the record shows that she is unable to parent Paula. Carol continually exposed Paula to domestic violence, substance abuse, and alcohol abuse. Additionally, Carol refuses to admit that alcohol is a problem for her.

The trial judge credited Dr. Weitz's testimony that although Paula would suffer some harm if Carol's parental rights were terminated, S.A would be able to mitigate that harm. Both defense experts agreed that Paula needs permanency and stability; however, the evidence shows that Carol is unable to provide that for Paula. Furthermore, S.A. has expressed the desire to adopt Paula. Thus, there is sufficient credible evidence in the record to support the conclusion that termination of Carol's parental rights will not do more harm than good. We are satisfied the record contains clear and convincing evidence to establish prong four.

Affirmed.

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